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A pharmacist in Scotland who suffered the shock of an unexpected leukaemia diagnosis four years ago drew on her experience to help diagnose the disease in a patient who came to her for a Pharmacy First consultation.

Victoria Lang, an independent prescriber from Banton in North Lanarkshire, told Community Pharmacy Scotland (CPS) “alarm bells” rang when the patient, who had been referred to the service by a GP, came to see her last autumn.

Having noticed the patient was unwell, Lang went through their medical history and found they recently suffered neutropenic episodes, allergies and intolerances to previously prescribed antibiotics and a sore throat.

Pharmacist identified multiple possible infections

CPS said Lang “identified multiple possible infections and noted the patient’s deteriorating health” before sending them to the GP “for an urgent same-day appointment”.

The Pharmacy First consultation took place during the week her pharmacy ran a leukaemia awareness campaign to coincide with Blood Cancer Awareness Month. The patient was diagnosed with leukaemia six weeks later.

CPS said Lang’s personal experience of the disease “allowed her and her pharmacy team to be vigilant” to signs such as persistent fatigue, unexplained bruising or bleeding, frequent infections, fever, night sweats, bone and joint pain and swollen lymph nodes.

“When (independent prescribing) training says assessment begins at the door, this really was the case for this interaction and on reflection, the patient’s demeanour and presentation that day did ring alarm bells for me,” she told CPS.

A powerful example of incredible patient care

“Although we refer multiple patients each week to their GP, we don’t usually get to know the outcome and I think we usually hope that our instincts are wrong.

“The experience has helped me to understand that initial assessment of the patient before any questions are asked guides our consultation and influence the outcome.”

CPS said her intervention was “a powerful example of incredible patient care” and highlighted “the vital role of the community pharmacy network in Scotland”.

It was in March 2021 when Lang was diagnosed with leukaemia having started bleeding heavily during what she described as an “abnormal period”.

She initially thought the bleeding had been caused by a Covid booster vaccine she had taken two days earlier. When the bleeding continued, she contacted her GP before being admitted to hospital after undergoing blood tests.

A diagnosis of acute promyelocytic leukaemia followed and she underwent treatment before making a recovery.